醫週譯:Brain tumor/腦瘤

為中文維基百科資料

A brain tumor or intracranial neoplasm occurs when abnormal cells form within the brain.[1] There are two main types of tumors: malignant or cancerous tumors and benign tumors.[1] Cancerous tumors can be divided into primary tumors that started within the brain and those that spread from somewhere else known as brain metastasis tumors.[2] All types of brain tumors may produce symptoms, that vary depending on the part of the brain involved.[1] These may includeheadaches, seizures, problem with vision, vomiting, and mental changes.[2] The headache is classically worst in the morning and goes away with vomiting.[1]More specific problems may include difficulty in walking, speaking and with sensation.[2][3] As the disease progresses unconsciousness may occur.[3]

’’’腦瘤’’’或’’’顱內腫瘤’’’是指[[腦]]內異常細胞的形成[1],定義為任何顱內腫瘤,發生的位置包括了腦本身各種細胞(神經元、膠質細胞、淋巴組織以及血管)、腦神經(許旺氏細胞)、腦膜、頭骨、腦下垂體以及由其它器官轉移的轉移性腦瘤[0]。主要分成兩種:惡性或[[癌症]]腫瘤,以及[[良性腫瘤]][1]。癌症腫瘤可再分為{{link-en|原發性腫瘤|Primary_tumor|原發性腦瘤}}與{{link-en|腦轉移|Brain_metastasis|轉移性腦瘤}}[2]。所有型態的腦瘤都會產生症狀,因為腦瘤漸漸增大必會壓住該處之[[神經]],影響其功能,所以臨床表現因部位不同而異[1],包含[[頭痛]]、{{link-en|抽搐|Epileptic seizure}}、[[視力]]問題、[[嘔吐]]、意識改變[2]。典型的頭痛為早晨時惡化,並伴隨嘔吐而頭痛減緩[1]。其他特殊的症狀包含行走、說話困難,以及感覺異常[2][3]。當疾病進展時,可能發生{{link-en|失去意識|Unconsciousness}}[3]。在惡性腦瘤晚期,[[腫瘤細胞]]也會轉移至身體其他臟器。

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The cause of most cases is unknown.[1] Risk factors that may occasionally be involved include: a number of genetic syndrome such as neurofibromatosis as well as exposure to the chemical vinyl chloride, Epstein-Barr virus, and ionizing radiation.[2][1][3] While concern has been raised about mobile phone use the evidence is not clear.[3] The most common types of primary tumors in adults are: meningiomas and astrocytomas such as glioblastomas.[2] In children the most common type is medulloblastomas.[3] Diagnosis is usually by medical examination along with computed tomography or magnetic resonance imaging.[1] This is than often confirmed by biopsy.[2] Based on the finding the tumors are divided into different grades or severity.[2]

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大部分腦瘤的發生原因不明[1]。某些危險因子可能牽涉其中,包括一些[[基因]][[症候群]]如{{link-en|神經纖維瘤|neurofibromatosis}},以及暴露於化學物質(如[[氯乙烯]])、[[人類疱疹病毒第四型]](Epstein-Barr virus)或[[游離輻射]][1][2][3]。而對於[[手機]]使用產生的相關疑慮,目前缺乏明確證據[3]。在成人病患中最常見的原發性腦瘤是{{link-en|腦膜瘤|meningiomas}}和{{link-en|星狀細胞瘤|astrocytomas}},後者如[[膠質母細胞瘤|神經膠母細胞瘤]](glioblastoma)[2];而在兒童病患中最常見的則是[[成神經管細胞瘤|髓母細胞瘤]](medulloblastoma)[3]。腦瘤的診斷以[[體格檢查|身體診察}}搭配[[電腦斷層掃描]](computed tomography)或[[核磁共振成像|磁共振影像]](magnetic resonance imaging)為主[1],之後會進行[[活體組織切片|切片]]檢查確認[2],再根據病理結果區分為不同等級或{{link-en|嚴重度|Grading of the tumors of the central nervous system}}[2]。

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Treatment may include some combination of surgery, radiation therapy and chemotherapy.[2]Anticonvulsant medication is needed in those who have a seizure.[2] Dexamethasone and furosemide may be used to decrease swelling around the tumor.[2] Some tumors grow sufficiently slowly that all that is required is keeping an eye on it.[2] Treatments that use a person’s immune system are being studied.[1] Outcomes depends on the type of tumor.[3] Gliobastomas usually have poor outcomes while meningiomas usually have good outcomes.[3] Average five year survival rates in the United States are 33%.[4]

<!-- 治療與預後 -->

治療方式可能綜合包括[[外科學|手術]]、[[放射線療法]]和[[化學療法]]數種方式[2]。若有抽搐情形可使用{{link-en|抗癲癇藥物|Anticonvulsant}}[2]。[[地塞米松|Dexamethasone]] (中國大陸譯:地塞米松;台灣醫界無正式譯名)與[[呋塞米|Furosemide]](中國大陸譯:呋塞米;台灣醫界無正式譯名)則可減少腫瘤周圍水腫[2]。部分腫瘤成長較緩慢,僅需要長期追蹤[2]。以病患的[[免疫系統]]作為治療方式,目前仍然在研究中[1]。預後則依腫瘤型態而定[3]。神經膠細胞瘤通常預後較差,而腦膜瘤較好[3]。在美國,腦瘤平均{{en-link|五年存活率|Five-year_survival_rate}}為33%[4]。

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Metastatic brain tumors are more common than primary brain tumors,[1] with about half of metastasis coming from lung cancer.[1] Primary brain tumors occur in around 250,000 people a year globally, making up less than 2% of cancers.[3] In children less than 15 brain tumors are second only to acute lymphoblastic leukemia as a cause of cancer.[5] In Australia the average economic costs of a case of brain cancer is $1.9 million, the greatest of any type of cancer.[6]

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轉移性腦瘤比原發性腦瘤常見[1],約有一半的轉移性腦瘤是來自[[肺癌]][1]。全球每年發生原發性腦瘤的人數約為250,000人,占所有癌症少於百分之二[3]。在15歲以下兒童族群中,腦瘤在癌症發生率排名中僅次於[[急性淋巴性白血病]][5]。在澳洲平均一個腦瘤個案所必須花費的金額為190萬元,為所有癌症之最[6]。

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